NPIMap

Individual provider Active NPI

Andre Mikael De Leon, MD

  • Family Medicine Physician
  • Delaware, OH
National Provider Identifier
1922281633
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.132410 Issued in OH
Practice address
801 Ohio Health Blvd Ste 260
Delaware, OH 43015-7870
Phone
(740) 615-0500
NPI assigned
Dec 17, 2007
Last updated
May 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 35.132410 OH
Family Medicine Physician 207Q00000X 35.132410 OH Primary

Addresses

Primary practice location

801 Ohio Health Blvd Ste 260
Delaware, OH 43015-7870

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

1264 Weaver Dr
Granville, OH 43023-1257
Phone (220) 564-1955

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adeleon367214@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703000432 OH Practitioner - Family Practice 0749475648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111115CAMDMarriage & Family Therapist
35.132410OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Dec 1, 2019 Accepting new patients
Ohiohealth Corporation CurrentSince Dec 1, 2019 Accepting new patients
Ohiohealth Corporation Family Medicine Current Accepting new patients
Ohiohealth Urgent Care LLC CurrentSince Apr 1, 2020 Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

801 Ohio Health Blvd
Ste 260
Delaware, OH 43015
Phone (740) 615-0500

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

6905 Hospital Dr
Ste 130
Dublin, OH 43016
Phone (614) 923-0300

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1922281633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OHIO HEALTH BLVD STE 260",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157870",
            "telephone_number": "740-615-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1264 Weaver Dr",
            "address_purpose": "LOCATION",
            "city": "Granville",
            "state": "OH",
            "postal_code": "430231257",
            "country_code": "US",
            "telephone_number": "220-564-1955",
            "fax_number": "220-564-1956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "ANDRE",
        "middle_name": "MIKAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35.132410",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.132410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adeleon367214@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "801 OhioHealth Blvd",
            "address_2": "Ste 260",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.